www.cms.gov: Accessibility — week 2026-W39

Automated Accessibility Conformance Report (OpenACR): Download ACR. Machine-readable; compatible with GSA OpenACR tooling. Automated tools find ~⅓ of real barriers — supplement with manual AT testing.

Training priorities

Top WCAG success criteria by pages affected this week. Use these to focus team training on the highest-impact issues.

SC	Criterion	Pages	Rules	Notes
1.4.8	WCAG 1.4.8	564	4	Component inconsistency
2.5.5	WCAG 2.5.5	377	1
1.4.1	Use of Color	372	2
1.3.1	Info and Relationships (semantic structure)	324	7
3.1.1	Language of Page	288	2

Next 10 actions

Clusters are fingerprinted by normalized selector path + rule id + snippet shape. Rank score = (severity weight × pages affected) / distinct components for the rule. This supersedes the template threshold heuristic while still surfacing it as a validation signal.

Design-system alignment (cms-ds / default). No design-system components detected in sampled findings.

Top 10 clustered component fixes for this week.
Cluster	Severity	Pages	Who it affects	How to fix	Evidence	Decision
<html> element must have a lang attribute · unattributed component Fix one place, resolve ~256 finding(s) on 256 page(s). XPath / selector: `html` `<html>`	Serious	256	Without vision, Limited cognitive, language, or learning ability	Add a lang attribute to <html> (e.g. lang="en").	pages (CSV)	Decision Assigned to Notes
Form field label is visible · unattributed component Fix one place, resolve ~346 finding(s) on 346 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	346	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
Document should have one main landmark · unattributed component Fix one place, resolve ~256 finding(s) on 256 page(s). XPath / selector: `html` `<html>`	Moderate	256	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~109 finding(s) on 109 page(s). XPath / selector: `text: "Feedback"`	Moderate	109	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
Images must have alternative text · unattributed component Fix one place, resolve ~245 finding(s) on 245 page(s). XPath / selector: `img[src$="cms-site-logo.png"]` `<img src="cms-site-logo.png">`	Critical	245	Without vision, Limited vision, Limited cognitive, language, or learning ability	Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.	pages (CSV)	Decision Assigned to Notes
Headings should not be empty · unattributed component Fix one place, resolve ~245 finding(s) on 245 page(s). XPath / selector: `h1:nth-child(2)` `<h1></h1>`	Minor	245	Requires manual testing.	Remove empty headings or give them text. Don't use heading tags for spacing.	pages (CSV)	Decision Assigned to Notes
Document has a valid lang attribute · unattributed component Fix one place, resolve ~32 finding(s) on 32 page(s). XPath / selector: `<html>`	Moderate	32	Without vision, Limited cognitive, language, or learning ability	Add a valid lang attribute to <html>.	pages (CSV)	Decision Assigned to Notes
Element has required owned roles · unattributed component Fix one place, resolve ~30 finding(s) on 30 page(s). XPath / selector: `<h1>`	Moderate	30	Without vision, Limited vision, Limited cognitive, language, or learning ability	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r64	pages (CSV)	Decision Assigned to Notes
Form elements must have labels · unattributed component Fix one place, resolve ~11 finding(s) on 11 page(s). XPath / selector: `#q` `<input type="text" name="q" id="q" value="Search now" size="10" maxlength="50" class="srchbox" onfocus="this.value='';">`	Critical	11	Without vision, Limited vision, Limited manipulation/strength	Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.	pages (CSV)	Decision Assigned to Notes
All page content should be contained by landmarks · unattributed component Fix one place, resolve ~315 finding(s) on 158 page(s). XPath / selector: `td[width="31"]:nth-child(3)` `<td width="31"><a accesskey="p" id="prev_page" href="P0243.html"><img src="bakpg.png" alt="Previous Page [Alt-p]" height="14" width="31" vspace="0" hspace="0" align="bottom" border="0"></a></td>`	Moderate	158	Requires manual testing.	Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.	pages (CSV)	Decision Assigned to Notes

Bug reports

11 issue type(s) are shown by default out of 32 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 2 critical, 6 serious, 22 moderate, 2 minor. By WCAG category: 9 WCAG 2.0 A, 3 WCAG 2.0 AA, 1 WCAG 2.2 AA, 2 WCAG 2.x AAA, 10 Best Practice, 7 Undetermined. Ordered by severity, key-page impact, WCAG level, and prevalence. Following accessibility bug-reporting best practices. Download: Markdown · JSON (full archive) · JSON (AI diagnostic) · CSV (all findings) · Priority pages CSV · Priority pages JSON.

Automated testing does not establish full WCAG conformance. Findings in the verification lane require manual testing before they are treated as confirmed failures.

Default view shows 11 prioritized issue type(s); 21 more are available if you switch to "Show everything".

1 finding(s) marked "possible duplicate" — Alfa and axe-core both flagged the same WCAG SC on overlapping pages. If they target the same element, the axe-core report is authoritative. Filter the CSV by possible_duplicate_of to see these. Two engines flagging the same barrier reduces the chance of a false positive.

Findings needing review

These findings need manual verification before they can be treated as confirmed failures. Obligation remains visible for each finding.

Serious axe html-has-lang WCAG 2.0 A <html> element must have a lang attribute (WCAG 3.1.1) 256/4208 pages · 256 instances Likely template

Bug ID: VS-f068b80b
Pattern ID: VS-c126b6a6
Combined ID: VS-f068b80b (pattern VS-c126b6a6) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: axe-core — <html> element must have a lang attribute [html-has-lang]
Example URL: https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 256 of 4208 scanned pages (256 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html.
Locate the element: html
Confirm the axe-core finding for rule html-has-lang against WCAG 3.1.1 Language of Page.

Impact

Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

…and more — all 256 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Add a lang attribute to <html> (e.g. lang="en").

Drupal tip: Drupal sets the page lang attribute from Admin › Configuration › Regional and Language › Languages. Ensure the default language is configured.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI

Triage status Notes

Critical axe image-alt WCAG 2.0 A Images must have alternative text (WCAG 1.1.1) 248/4208 pages · 253 instances Likely template

Bug ID: VS-85cfbbc4
Pattern ID: VS-9074b4dd
Combined ID: VS-85cfbbc4 (pattern VS-9074b4dd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: axe-core — Images must have alternative text [image-alt]
Example URL: https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
XPath / selector: img[src$="cms-site-logo.png"]
History: first seen 2026-W24, last seen 2026-W39 (15 wk)

HTML snippet — use this to validate the finding without re-running the tool

<img src="cms-site-logo.png">

Description

Images must have alternative text. Detected by axe-core rule image-alt on 248 of 4208 scanned pages (253 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html.
Locate the element: img[src$="cms-site-logo.png"]
Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

…and more — all 248 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.

Drupal tip: In Drupal's Media Library, fill the "Alternative text" field when uploading or editing an image. For images in body fields, the CKEditor "Image Properties" dialog includes an Alt Text field.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI

Triage status Notes

Critical axe label WCAG 2.0 A Form elements must have labels (WCAG 4.1.2) 11/4208 pages · 11 instances Likely template

Bug ID: VS-7d1c9620
Pattern ID: VS-fafffee0
Combined ID: VS-7d1c9620 (pattern VS-fafffee0) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Form elements must have labels [label]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
XPath / selector: #q
History: first seen 2026-W26, last seen 2026-W39 (14 wk)

HTML snippet — use this to validate the finding without re-running the tool

<input type="text" name="q" id="q" value="Search now" size="10" maxlength="50" class="srchbox" onfocus="this.value='';">

Description

Form elements must have labels. Detected by axe-core rule label on 11 of 4208 scanned pages (11 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html.
Locate the element: #q
Confirm the axe-core finding for rule label against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.

Drupal tip: Use Drupal's form element "Label" setting. In Webform, every element has a Label field — ensure it's not empty or hidden. Check that twig templates don't strip <label> elements from form fields.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/label?application=axeAPI

Triage status Notes

Serious axe color-contrast WCAG 2.0 AA Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3) 11/4208 pages · 209 instances Likely template

Bug ID: VS-a7bceebd
Pattern ID: VS-be8d563e
Combined ID: VS-a7bceebd (pattern VS-be8d563e) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.3 Contrast (Minimum) (Level AA, WCAG 2.0)
Rule: axe-core — Elements must meet minimum color contrast ratio thresholds [color-contrast]
Example URL: http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
XPath / selector: .watermark
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<p class="watermark">DRAFT</p>

Description

Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 43 of 4208 scanned pages (474 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html.
Locate the element: .watermark
Confirm the axe-core finding for rule color-contrast against WCAG 1.4.3 Contrast (Minimum).

Impact

Affects Limited vision (2.4%), Without color perception (4.5%).

Limited vision — 2.4% of population
Without color perception — 4.5% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Increase the contrast between text and its background to at least 4.5:1 (3:1 for large text). Check both light and dark modes.

Drupal tip: Check your Drupal theme's base CSS. Themes like Olivero and Bartik have contrast issues in default color schemes — override failing color pairs in your subtheme's style.css.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI

Triage status Notes

Serious axe link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 3/4208 pages · 4 instances

Bug ID: VS-408cbf08
Pattern ID: VS-e9fe47ac
Combined ID: VS-408cbf08 (pattern VS-e9fe47ac) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: axe-core — Links must have discernible text [link-name]
Example URL: https://www.cms.gov/newsroom/press-releases/new-participants-join-several-cms-alternative-payment-models
XPath / selector: a[data-once="linkMatch"]:nth-child(3)
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<a href="https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprog/Downloads/2017-MSP-Fact-Sheet.pdf" data-once="linkMatch"><br></a>

Description

Links must have discernible text. Detected by axe-core rule link-name on 3 of 4208 scanned pages (4 instances).

Steps to reproduce

Open https://www.cms.gov/newsroom/press-releases/new-participants-join-several-cms-alternative-payment-models.
Locate the element: a[data-once="linkMatch"]:nth-child(3)
Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context).

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give the link discernible text. Avoid empty links and icon-only links without an aria-label.

Drupal tip: "Read more" links from Drupal Views should use the "Link text" rewrite field to add context, or add aria-label via the Views rewrite output.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI

Triage status Notes

Serious axe td-headers-attr WCAG 2.0 A Table cell headers attributes must refer to other <th> elements in the same tabl (WCAG 1.3.1) 3/4208 pages · 3 instances

Bug ID: VS-9c5c3291
Pattern ID: VS-07ba3b17
Combined ID: VS-9c5c3291 (pattern VS-07ba3b17) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — Table cell headers attributes must refer to other <th> elements in the same tabl [td-headers-attr]
Example URL: https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=5&sort=desc
XPath / selector: .MsoTableGrid
History: first seen 2026-W25, last seen 2026-W39 (15 wk)

HTML snippet — use this to validate the finding without re-running the tool

<table class="MsoTableGrid">

Description

Table cell headers attributes must refer to other <th> elements in the same tabl. Detected by axe-core rule td-headers-attr on 3 of 4208 scanned pages (3 instances).

Steps to reproduce

Open https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=5&sort=desc.
Locate the element: .MsoTableGrid
Confirm the axe-core finding for rule td-headers-attr against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Associate data cells with their headers correctly using headers/id or scope.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/td-headers-attr?application=axeAPI

Triage status Notes

Serious axe valid-lang WCAG 2.0 AA lang attribute must have a valid value (WCAG 3.1.2) 1/4208 pages · 1 instances Likely content

Bug ID: VS-8f470a84
Pattern ID: VS-dd1c019f
Combined ID: VS-8f470a84 (pattern VS-dd1c019f) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 3.1.2 Language of Parts (Level AA, WCAG 2.0)
Rule: axe-core — lang attribute must have a valid value [valid-lang]
Example URL: https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings
XPath / selector: a[href$="#_ftnref1"] > span[lang="X-NONE"]
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<span lang="X-NONE">[1]</span>

Description

lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 4208 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings.
Locate the element: a[href$="#_ftnref1"] > span[lang="X-NONE"]
Confirm the axe-core finding for rule valid-lang against WCAG 3.1.2 Language of Parts.

Impact

Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI

Triage status Notes

Serious axe accesskeys Best Practice accesskey attribute value should be unique (WCAG criterion undetermined) 87/4208 pages · 261 instances Likely template

Bug ID: VS-25377ac5
Pattern ID: VS-bd13f00a
Combined ID: VS-25377ac5 (pattern VS-bd13f00a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — accesskey attribute value should be unique [accesskeys]
Example URL: http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
XPath / selector: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0220.html"]
History: first seen 2026-W25, last seen 2026-W39 (13 wk)

HTML snippet — use this to validate the finding without re-running the tool

<a accesskey="p" id="prev_page" href="P0220.html"><img src="bakpg.png" alt="Previous Page [Alt-p]" height="14" width="31" vspace="0" hspace="0" align="bottom" border="0"></a>

Description

accesskey attribute value should be unique. Detected by axe-core rule accesskeys on 87 of 4208 scanned pages (261 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html.
Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0220.html"]
Confirm the axe-core finding for rule accesskeys.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 87 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/accesskeys?application=axeAPI

Triage status Notes

Moderate alfa sia-r4 WCAG 2.0 A Document has a valid lang attribute (WCAG 3.1.1) 32/4208 pages · 32 instances Likely template

Bug ID: VS-b252cb89
Pattern ID: VS-7a0e5645
Combined ID: VS-b252cb89 (pattern VS-7a0e5645) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Document has a valid lang attribute [sia-r4]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
XPath / selector: <html>
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 32 of 4208 scanned pages (32 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html.
Locate the element: <html>
Confirm the Siteimprove Alfa finding for rule sia-r4 against WCAG 3.1.1 Language of Page.

Impact

Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

…and more — all 32 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Add a valid lang attribute to <html>.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r4

Triage status Notes

Moderate alfa sia-r64 WCAG 2.0 A Element has required owned roles (WCAG 1.3.1) 30/4208 pages · 30 instances Likely template

Bug ID: VS-2305b4b8
Pattern ID: VS-3c632d31
Combined ID: VS-2305b4b8 (pattern VS-3c632d31) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Element has required owned roles [sia-r64]
Example URL: http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html
XPath / selector: <h1>
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 30 of 4208 scanned pages (30 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html.
Locate the element: <h1>
Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

…and more — all 30 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r64

Triage status Notes

Moderate alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 24/4208 pages · 34 instances Likely template

Bug ID: VS-a3e35fc8
Pattern ID: VS-a24eaa8c
Combined ID: VS-a3e35fc8 (pattern VS-a24eaa8c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Image has accessible name [sia-r2]
Example URL: http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html
XPath / selector: <img src="cms-site-logo.png">
History: first seen 2026-W24, last seen 2026-W39 (15 wk)

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 31 of 4208 scanned pages (35 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html.
Locate the element: <img src="cms-site-logo.png">
Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give every <img> an accessible name (alt text), or alt="" if purely decorative.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r2

Triage status Notes

Moderate axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 256/4208 pages · 4294 instances Likely template

Bug ID: VS-ec0c6c71
Pattern ID: VS-f18df681
Combined ID: VS-ec0c6c71 (pattern VS-f18df681) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — All page content should be contained by landmarks [region]
Example URL: https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
XPath / selector: .arrows > tbody > tr:nth-child(1)
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<tr>
		<td><img src="cms-site-logo.png"></td>
		<td style="text-align:center;"><h1>ICD-10-CM/PCS MS-DRG v42.0 Definitions Manual</h1><h1></h1></td>
		<td></td>
		<td></td>
		<td></td>
	</tr>

Description

All page content should be contained by landmarks. Detected by axe-core rule region on 256 of 4208 scanned pages (4294 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html.
Locate the element: .arrows > tbody > tr:nth-child(1)
Confirm the axe-core finding for rule region.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 256 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.

Drupal tip: Use Drupal's region system (header, navigation, main, sidebar, footer) and map each to an HTML5 landmark element in your theme's page.html.twig.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI

Triage status Notes

Moderate axe landmark-one-main Best Practice Document should have one main landmark (WCAG criterion undetermined) 256/4208 pages · 256 instances Likely template

Bug ID: VS-0e54c170
Pattern ID: VS-d5d82446
Combined ID: VS-0e54c170 (pattern VS-d5d82446) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Document should have one main landmark [landmark-one-main]
Example URL: https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

Document should have one main landmark. Detected by axe-core rule landmark-one-main on 256 of 4208 scanned pages (256 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html.
Locate the element: html
Confirm the axe-core finding for rule landmark-one-main.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 256 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Each page should have exactly one <main> landmark.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI

Triage status Notes

Minor axe empty-heading Best Practice Headings should not be empty (WCAG criterion undetermined) 247/4208 pages · 247 instances Likely template

Bug ID: VS-4fe31561
Pattern ID: VS-0066c67d
Combined ID: VS-4fe31561 (pattern VS-0066c67d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Headings should not be empty [empty-heading]
Example URL: https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
XPath / selector: h1:nth-child(2)
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<h1></h1>

Description

Headings should not be empty. Detected by axe-core rule empty-heading on 247 of 4208 scanned pages (247 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html.
Locate the element: h1:nth-child(2)
Confirm the axe-core finding for rule empty-heading.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 247 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Remove empty headings or give them text. Don't use heading tags for spacing.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI

Triage status Notes

Moderate alfa sia-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 109/4208 pages · 109 instances Likely template

Bug ID: VS-8bbb1623
Pattern ID: VS-c18be945
Combined ID: VS-8bbb1623 (pattern VS-c18be945) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Scrolling content can be accessed by keyboard [sia-r57]
Example URL: https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
XPath / selector: text: "Feedback"
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 109 of 4208 scanned pages (109 instances).

Steps to reproduce

Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
Locate the element: text: "Feedback"
Confirm the Siteimprove Alfa finding for rule sia-r57.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 109 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57

Triage status Notes

Moderate axe page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 17/4208 pages · 17 instances Likely template

Bug ID: VS-5705c648
Pattern ID: VS-fa44f293
Combined ID: VS-5705c648 (pattern VS-fa44f293) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Page should contain a level-one heading [page-has-heading-one]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 17 of 4208 scanned pages (17 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html.
Locate the element: html
Confirm the axe-core finding for rule page-has-heading-one.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI

Triage status Notes

Moderate alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 13/4208 pages · 6345 instances Likely template

Bug ID: VS-836f94b9
Pattern ID: VS-cb53cc4d
Combined ID: VS-836f94b9 (pattern VS-cb53cc4d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 2.5.5 Target Size (Enhanced) (Level AAA, WCAG 2.1)
Rule: Siteimprove Alfa — Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]
Example URL: https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
XPath / selector: <a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 377 of 4208 scanned pages (12202 instances).

Steps to reproduce

Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
Locate the element: <a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">
Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111

Triage status Notes

Moderate deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 13/4208 pages · 889 instances Likely template

Bug ID: VS-f58181dd
Pattern ID: VS-04a9d28c
Combined ID: VS-f58181dd (pattern VS-04a9d28c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: deprecated-html — Presentational attribute (use CSS) [presentational-attr]
Example URL: https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=82&sortBy=meetingdate&year=all
XPath / selector: p
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<p class="MsoNormal" align="center" style="text-align:center"><strong><a name="agenda">Agenda</a><br>Medicare Evidence Development &amp; Coverage Advisory Committee<br>June 25, 2025<br>10:00 AM – 2:00

Description

Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 40 of 4208 scanned pages (1710 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=82&sortBy=meetingdate&year=all.
Locate the element: p
Confirm the deprecated-html finding for rule presentational-attr.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

Not captured by automated scan — requires manual testing.

Triage status Notes

Moderate alfa sia-r73 WCAG 2.x AAA Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8) 12/4208 pages · 1862 instances Likely template

Bug ID: VS-12ecb7bd
Pattern ID: VS-2208081b
Combined ID: VS-12ecb7bd (pattern VS-2208081b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has minimum contrast ratio of 4.5:1 [sia-r73]
Example URL: https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
XPath / selector: <p class="ds-c-usa-banner__header-text">
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 367 of 4208 scanned pages (3880 instances).

Steps to reproduce

Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
Locate the element: <p class="ds-c-usa-banner__header-text">
Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73

Triage status Notes

Moderate alfa sia-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 12/4208 pages · 166 instances Likely template

Bug ID: VS-1495eb94
Pattern ID: VS-7118fead
Combined ID: VS-1495eb94 (pattern VS-7118fead) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field label is visible [sia-r61]
Example URL: https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 346 of 4208 scanned pages (346 instances).

Steps to reproduce

Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r61.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61

Triage status Notes

Minor axe empty-table-header Best Practice Table header text should not be empty (WCAG criterion undetermined) 8/4208 pages · 19 instances Likely template

Bug ID: VS-001a37bc
Pattern ID: VS-d69fc059
Combined ID: VS-001a37bc (pattern VS-d69fc059) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Table header text should not be empty [empty-table-header]
Example URL: https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all
XPath / selector: table[width="75%"] > tbody > tr:nth-child(1) > th:nth-child(1)
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<th></th>

Description

Table header text should not be empty. Detected by axe-core rule empty-table-header on 28 of 4208 scanned pages (59 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all.
Locate the element: table[width="75%"] > tbody > tr:nth-child(1) > th:nth-child(1)
Confirm the axe-core finding for rule empty-table-header.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI

Triage status Notes

Moderate alfa sia-r113 WCAG 2.2 AA Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8) 7/4208 pages · 71 instances Likely template

Bug ID: VS-502c16a0
Pattern ID: VS-179ad9b3
Combined ID: VS-502c16a0 (pattern VS-179ad9b3) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.2 AA
Obligation: required
Handling: review
WCAG SC: 2.5.8 Target Size (Minimum) (Level AA, WCAG 2.2)
Rule: Siteimprove Alfa — Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
XPath / selector: <a href="http://www.cms.gov/" title="CMS Home Page">
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 79 of 4208 scanned pages (252 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html.
Locate the element: <a href="http://www.cms.gov/" title="CMS Home Page">
Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

Impact

Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%).

Limited manipulation/strength — 13.0% of population
Limited reach — 2.0% of population
Limited vision — 2.4% of population

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r113

Triage status Notes

Moderate axe scope-attr-valid Best Practice scope attribute should be used correctly (WCAG criterion undetermined) 6/4208 pages · 166 instances Likely template

Bug ID: VS-ebeb81f2
Pattern ID: VS-0ba8ce9d
Combined ID: VS-ebeb81f2 (pattern VS-0ba8ce9d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — scope attribute should be used correctly [scope-attr-valid]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
XPath / selector: th[scope="colwidth=10"]
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<th scope="colwidth=10">&nbsp;</th>

Description

scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 38 of 4208 scanned pages (692 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html.
Locate the element: th[scope="colwidth=10"]
Confirm the axe-core finding for rule scope-attr-valid.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI

Triage status Notes

Moderate axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 6/4208 pages · 64 instances Likely template

Bug ID: VS-a9b7d64e
Pattern ID: VS-d25f622d
Combined ID: VS-a9b7d64e (pattern VS-d25f622d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Heading levels should only increase by one [heading-order]
Example URL: https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
XPath / selector: .content > h3:nth-child(2)
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

HTML snippet — use this to validate the finding without re-running the tool

<h3>End User Point and Click Agreement:</h3>

Description

Heading levels should only increase by one. Detected by axe-core rule heading-order on 265 of 4208 scanned pages (268 instances).

Steps to reproduce

Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
Locate the element: .content > h3:nth-child(2)
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.

Drupal tip: Drupal Views and blocks can insert headings at arbitrary levels. In the Views UI, set "Title tag" for each display. For block titles, configure the heading level in the block's layout settings.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI

Triage status Notes

Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 6/4208 pages · 32 instances Likely template

Bug ID: VS-e1dec2f9
Pattern ID: VS-2cd767ca
Combined ID: VS-e1dec2f9 (pattern VS-2cd767ca) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Table header has scope [sia-r78]
Example URL: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26
XPath / selector: <h4>
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 101 of 4208 scanned pages (135 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26.
Locate the element: <h4>
Confirm the Siteimprove Alfa finding for rule sia-r78.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r78

Triage status Notes

Moderate alfa sia-r53 Undetermined Headings are structured hierarchically (WCAG criterion undetermined) 2/4208 pages · 13 instances Likely template

Bug ID: VS-23c72855
Pattern ID: VS-f054f4a4
Combined ID: VS-23c72855 (pattern VS-f054f4a4) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Headings are structured hierarchically [sia-r53]
Example URL: https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
XPath / selector: <h3>
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 167 of 4208 scanned pages (167 instances).

Steps to reproduce

Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
Locate the element: <h3>
Confirm the Siteimprove Alfa finding for rule sia-r53.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Use headings in a logical, non-skipping order.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53

Triage status Notes

Moderate alfa sia-r77 WCAG 2.0 A Table cell has header (WCAG 1.3.1) 2/4208 pages · 11 instances · possible duplicate

Bug ID: VS-4f01ca09
Pattern ID: VS-3f067795
Combined ID: VS-4f01ca09 (pattern VS-3f067795) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Table cell has header [sia-r77]
Example URL: https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html
XPath / selector: <td colspan="4" class="itl">
History: first seen 2026-W24, last seen 2026-W39 (16 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-9c5c3291 (pattern VS-07ba3b17). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 5 of 4208 scanned pages (27 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html.
Locate the element: <td colspan="4" class="itl">
Confirm the Siteimprove Alfa finding for rule sia-r77 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r77

Triage status Notes

Moderate alfa sia-r75 Undetermined Form field error is identified and described (WCAG criterion undetermined) 2/4208 pages · 4 instances Likely content

Bug ID: VS-e38ca52c
Pattern ID: VS-e43903a1
Combined ID: VS-e38ca52c (pattern VS-e43903a1) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field error is identified and described [sia-r75]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
XPath / selector: <ul id="globar">
History: first seen 2026-W26, last seen 2026-W39 (13 wk)

Description

Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 2 of 4208 scanned pages (4 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html.
Locate the element: <ul id="globar">
Confirm the Siteimprove Alfa finding for rule sia-r75.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r75

Triage status Notes

Moderate alfa sia-r59 Undetermined Element with orientation is not locked (WCAG criterion undetermined) 2/4208 pages · 2 instances Likely content

Bug ID: VS-ad8e9e76
Pattern ID: VS-7fbb8b20
Combined ID: VS-ad8e9e76 (pattern VS-7fbb8b20) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Element with orientation is not locked [sia-r59]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
XPath / selector: {"type":"document","children":[{"type":"element","children":[{"type":"element","
History: first seen 2026-W26, last seen 2026-W39 (13 wk)

Description

Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 2 of 4208 scanned pages (2 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html.
Locate the element: {"type":"document","children":[{"type":"element","children":[{"type":"element","
Confirm the Siteimprove Alfa finding for rule sia-r59.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r59

Triage status Notes

Moderate axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 2/4208 pages · 2 instances Likely content

Bug ID: VS-46fc585c
Pattern ID: VS-8806389c
Combined ID: VS-46fc585c (pattern VS-8806389c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Landmarks should have a unique role or role/label/title (i.e. accessible name) c [landmark-unique]
Example URL: https://www.cms.gov/about-cms/contact/newsroom
XPath / selector: .views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)
History: first seen 2026-W25, last seen 2026-W39 (15 wk)

HTML snippet — use this to validate the finding without re-running the tool

<span class="views-field views-field-field-topic" role="region" aria-label="Related search topics">
<a href="/newsroom/search?about[]=33506&amp;keys= " data-once="linkMatch">Administration</a>
</span>

Description

Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 2 of 4208 scanned pages (2 instances).

Steps to reproduce

Open https://www.cms.gov/about-cms/contact/newsroom.
Locate the element: .views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)
Confirm the axe-core finding for rule landmark-unique.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: When a landmark role/type repeats (e.g. two <nav>s), give each a distinct accessible name with aria-label or aria-labelledby (e.g. "Primary" and "Footer" navigation) so screen-reader users can tell them apart.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI

Triage status Notes

Moderate alfa sia-r69 WCAG 2.0 AA Text has sufficient color contrast (Enhanced) (WCAG 1.4.3) 1/4208 pages · 9 instances

Bug ID: VS-e1384346
Pattern ID: VS-f7e99f4b
Combined ID: VS-e1384346 (pattern VS-f7e99f4b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.3 Contrast (Minimum) (Level AA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has sufficient color contrast (Enhanced) [sia-r69]
Example URL: http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36704&lcdStatus=all&sortBy=title&ver=23
XPath / selector: text: "Clinicopathologic Findings"
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 5 of 4208 scanned pages (44 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36704&lcdStatus=all&sortBy=title&ver=23.
Locate the element: text: "Clinicopathologic Findings"
Confirm the Siteimprove Alfa finding for rule sia-r69 against WCAG 1.4.3 Contrast (Minimum).

Impact

Affects Limited vision (2.4%), Without color perception (4.5%).

Limited vision — 2.4% of population
Without color perception — 4.5% of population

Affected pages

/priorities/innovation/innovation-models/bpci-advanced

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Increase text contrast to meet WCAG AA (4.5:1, or 3:1 for large text).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r69

Triage status Notes

Moderate axe landmark-banner-is-top-level Best Practice Banner landmark should not be contained in another landmark (WCAG criterion undetermined) 1/4208 pages · 1 instances Likely content

Bug ID: VS-309f8928
Pattern ID: VS-30db094d
Combined ID: VS-309f8928 (pattern VS-30db094d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Banner landmark should not be contained in another landmark [landmark-banner-is-top-level]
Example URL: http://www.cms.gov/data-research/statistics-trends-reports/next-generation-aco-model-ngaco-public-use-files
XPath / selector: .Header
History: first seen 2026-W24, last seen 2026-W39 (11 wk)

HTML snippet — use this to validate the finding without re-running the tool

<header class="Header" style="position: sticky;">

Description

Banner landmark should not be contained in another landmark. Detected by axe-core rule landmark-banner-is-top-level on 1 of 4208 scanned pages (1 instances).

Steps to reproduce

Open http://www.cms.gov/data-research/statistics-trends-reports/next-generation-aco-model-ngaco-public-use-files.
Locate the element: .Header
Confirm the axe-core finding for rule landmark-banner-is-top-level.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/data-research/statistics-trends-reports/next-generation-aco-model-ngaco-public-use-files

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Put the banner landmark (<header>) at the top level, not nested inside another landmark.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI

Triage status Notes

Deque axe-core findings

Rule-level axe-core summary (21 rule type(s))

Each failing rule links out to the axe-core documentation. For full element-level detail including HTML snippets and XPaths, see the bug reports above.

axe-core rules failing in 2026-W39, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Links must be distinguishable without relying on color [link-in-text-block]	serious	366	844	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 366 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	265	268	/apps/ama/license.asp /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx	all 265 pages (CSV)
All page content should be contained by landmarks [region]	moderate	256	4294	/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html /icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html /icd10m/version33-fullcode-cms/fullcode_cms/P1071.html	all 256 pages (CSV)
<html> element must have a lang attribute [html-has-lang]	serious	256	256	/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html /icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html /icd10m/version33-fullcode-cms/fullcode_cms/P1071.html	all 256 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	256	256	/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html /icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html /icd10m/version33-fullcode-cms/fullcode_cms/P1071.html	all 256 pages (CSV)
Images must have alternative text [image-alt]	critical	248	253	/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html /icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html /icd10m/version38-fullcode-cms/fullcode_cms/P0025.html	all 248 pages (CSV)
Headings should not be empty [empty-heading]	minor	247	247	/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html /icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html /icd10m/version38-fullcode-cms/fullcode_cms/P0025.html	all 247 pages (CSV)
<ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]	serious	210	933	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx	all 210 pages (CSV)
accesskey attribute value should be unique [accesskeys]	serious	87	261	/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html /icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0246.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0201.html	all 87 pages (CSV)
Elements must meet minimum color contrast ratio thresholds [color-contrast]	serious	43	474	/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html /icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0246.html /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 43 pages (CSV)
scope attribute should be used correctly [scope-attr-valid]	moderate	38	692	/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html /medicare-coverage-database/view/medcac-meeting.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 38 pages (CSV)
Table header text should not be empty [empty-table-header]	minor	28	59	/medicare-coverage-database/view/ncacal-decision-memo.aspx /icd10m/version33-fullcode-cms/fullcode_cms/P1071.html /medicare-coverage-database/view/medcac-meeting.aspx	all 28 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	17	17	/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html /medicaid-chip/community-engagement-support/eligibility-made-easy /icd10m/version33-fullcode-cms/fullcode_cms/P0588.html	all 17 pages (CSV)
<li> elements must be contained in a <ul> or <ol> [listitem]	serious	11	147	/medicare-coverage-database/view/medcac-meeting.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 11 pages (CSV)
Form elements must have labels [label]	critical	11	11	/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html /icd10m/version33-fullcode-cms/fullcode_cms/P0588.html /icd10m/version33-fullcode-cms/fullcode_cms/P1308.html	all 11 pages (CSV)
Links must have discernible text [link-name]	serious	3	4	/newsroom/press-releases/new-participants-join-several-cms-alternative-payment-models /newsroom/fact-sheets/september-30-2015-effectuated-enrollment-snapshot /medicare/quality/clinical-laboratory-improvement-amendments	all 3 pages (CSV)
Table cell headers attributes must refer to other <th> elements in the same table [td-headers-attr]	serious	3	3	/medicare/regulations-guidance/transmittals/2020-transmittals /medicare/regulations-guidance/transmittals/2020-transmittals /medicare/regulations-guidance/transmittals/2020-transmittals	all 3 pages (CSV)
Scrollable region must have keyboard access [scrollable-region-focusable]	serious	2	2	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 2 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	2	2	/about-cms/contact/newsroom /apps/media/press/release.asp	all 2 pages (CSV)
lang attribute must have a valid value [valid-lang]	serious	1	1	/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings	all 1 pages (CSV)
Banner landmark should not be contained in another landmark [landmark-banner-is-top-level]	moderate	1	1	/data-research/statistics-trends-reports/next-generation-aco-model-ngaco-public-use-files	all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (24 rule type(s))

Rule-level summary from Siteimprove Alfa (W3C ACT-based). Findings that overlap with axe-core on the same WCAG success criterion are noted as possible duplicates in the bug reports above.

Alfa rules failing in 2026-W39, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	377	12202	/apps/ama/license.asp /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 377 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	367	3880	/apps/ama/license.asp /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 367 pages (CSV)
Form field label is visible [sia-r61]	n/a	346	346	/apps/ama/license.asp /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 346 pages (CSV)
Text has enhanced contrast [sia-r66]	n/a	182	1114	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 182 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	182	417	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 182 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	181	13011	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 181 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	167	167	/apps/ama/license.asp /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 167 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	109	109	/apps/ama/license.asp /newsroom/press-releases/medicare-cover-aprepitant-emendr-part-three-drug-regimen-chemotherapy-induced-nausea-and-vomiting /about-cms/what-we-do/emergency-response/current-emergencies	all 109 pages (CSV)
Table header has scope [sia-r78]	n/a	101	135	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx	all 101 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	79	252	/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/ncd.aspx	all 79 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	45	114	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx	all 45 pages (CSV)
Document has a valid lang attribute [sia-r4]	n/a	32	32	/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html	all 32 pages (CSV)
Image has accessible name [sia-r2]	n/a	31	35	/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html /icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0217.html	all 31 pages (CSV)
Element has required owned roles [sia-r64]	n/a	30	30	/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html /icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0217.html	all 30 pages (CSV)
Element has required aria-owns [sia-r46]	n/a	20	36	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 20 pages (CSV)
Scrollable element is keyboard accessible [sia-r80]	n/a	8	122	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 8 pages (CSV)
iframe element is not empty [sia-r71]	n/a	8	44	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 8 pages (CSV)
Link in text block is visually distinguishable without color [sia-r62]	n/a	6	12	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 6 pages (CSV)
Text has sufficient color contrast (Enhanced) [sia-r69]	n/a	5	44	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /priorities/innovation/innovation-models/bpci-advanced	all 5 pages (CSV)
Table cell has header [sia-r77]	n/a	5	27	/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html /medicare-coverage-database/view/medcac-meeting.aspx /medicare-coverage-database/view/lcd.aspx	all 5 pages (CSV)
Duplicate role landmark is labeled [sia-r79]	n/a	5	5	/medicare-coverage-database/details/nca-proposed-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 5 pages (CSV)
Form field error is identified and described [sia-r75]	n/a	2	4	/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html /icd10m/version33-fullcode-cms/fullcode_cms/P0279.html	all 2 pages (CSV)
Element with orientation is not locked [sia-r59]	n/a	2	2	/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html /icd10m/version33-fullcode-cms/fullcode_cms/P0279.html	all 2 pages (CSV)
No obsolete or deprecated elements are used [sia-r70]	n/a	1	1	/medicare-coverage-database/view/medcac-meeting.aspx	all 1 pages (CSV)

Unique accessibility issues (axe + Alfa consolidated)

axe and Alfa both implement W3C ACT rules, so the same issue is often caught by both. These are deduplicated by ACT rule and page, so a shared finding counts once (4642 raw engine findings → 4549 unique).

Unique issues (rule × page): 4549
Caught by both engines: 93 highest confidence
axe only: 2258
Alfa only: 2198

3 rule type(s) caught by both engines — highest confidence

Two independent ACT-rule implementations (Deque axe-core and Siteimprove Alfa) flagged the same issue on the same pages. Agreement between separate engines is strong evidence the barrier is real, not a single-tool false positive — the best place to start.

Rules flagged by both axe-core and Alfa in 2026-W39, by pages affected.
Issue	Pages	Rule references
<html> element must have a lang attribute	256	axe html-has-lang · Alfa sia-r4 · ACT b5c3f8
Images must have alternative text	248	axe image-alt · Alfa sia-r2 · ACT 23a2a8
Headings should not be empty	247	axe empty-heading · Alfa sia-r64 · ACT ffd0e9